More than half of all Americans without health insurance currently live in states, such as Idaho, that are not planning any Medicaid expansion

When the 2013 Idaho Legislature packed up for the year in April, it had approved the machinations that would help build a health insurance exchange which, as part of the Affordable Care Act, will begin taking applications from Gem State residents as early as this October.

But Idaho lawmakers refused to consider any expansion of Medicaid and, according to this morning's New York Times, Idaho and other states' refusal to expand Medicaid "will leave millions of poor people ineligible for government subsidized health insurance," under the ACA, "even as many others with higher incomes receive federal subsidies to buy insurance." More than half of all Americans without health insurance currently live in states, such as Idaho, that are not planning any Medicaid expansion.

The Urban Institute estimates that 5.7 million uninsured adults with incomes below the poverty level might be able to gain coverage but are left on the sidelines in states that are not expanding Medicaid.

In 2014, Americans are required to secure health insurance and could be subject to fines without coverage, but penalties will not apply to low-income individuals and families denied access to Medicaid because they live in states that will deny Medicaid expansion.